Endoscopic treatment of postoperative esophagogastric leaks with fully covered self-expanding metal stents

• Elena Iglesias Jorquera ^[1] ; Juan Egea Valenzuela ^[1] ; Andrés Serrano Jiménez ^[1] ; Gabriel Carrilero Zaragoza ^[1] ; Antonio Ortega Sabater ^[1] ; Eduardo Sánchez Velasco ^[1] ; David Ruiz de Angulo ^[1] ; Vicente Munitiz ^[1] ; Pascual Parrilla ^[1] ; Fernando Alberca de las Parras ^[1]
  1. [1] Hospital Virgen de la Arrixaca

     Hospital Virgen de la Arrixaca

     Murcia, España

     
• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 113, Nº. 1, 2021, págs. 14-22
• Idioma: inglés
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• Resumen

  • Background: the management of postoperative esophageal leaks is a huge therapeutic challenge. Thanks to the advances in endoscopy, treatment with esophageal stents has been proposed as a valid option. Aims: the main objective of the study was to evaluate the effectiveness and safety of the use of fully covered esophageal metal stents in the treatment of postoperative esophageal leaks. Methods: a retrospective observational study was performed in patients with postoperative esophageal leaks, treated with fully covered self-expandable metal stents between June 2011 and May 2018. Results: twenty-five patients were evaluated and 34 stents were placed. The closure of the leak was observed in 21 patients after removal of the stent, with an overall technical success rate of 84 %. The mean time with a stent placed for closure of the fistula was 55.7 ± 27.11 days/patient (mean of 39 ± 24.30 days/stent). The most frequent complication was a partial distal stent migration (7/34 stents), followed by five cases of complete migration into the stomach. Conclusions: endoscopic treatment with fully covered self-expandable metal stents seems to be an effective and safe first-line treatment for postoperative esophageal leaks, according to the experience in our center.